Role of Case Management in Access to Mental Health Care Among African Americans With Medicaid

Disparity in access to appropriate mental health care among African Americans compared to non-Hispanic Whites is growing. The purpose of this quantitative retrospective study was to examine the relationship between access to an outpatient mental health facility with case management and access to outpatient mental health services among African Americans with Medicaid compared to non-Hispanic Whites with Medicaid. The theoretical framework was based on the conceptual framework for integration created by PATH. The study addressed whether there is a difference in the number of African Americans compared to non-Hispanic White patients with Medicaid in access to an outpatient mental health facility with a case manager. In addition, the study addressed whether there is a difference across ethnicities in access to mental health care as measured by the number of completed mental health assessments between Medicaid patients with a case manager compared to those without a case manager. Secondary data from the 2016 National Mental Health Services Survey were analyzed using chi-square and logistic regression analyses. Results showed that African Americans were less likely to have access to an outpatient facility with a case manager, in addition to even when given a case manager were less likely to have access to mental health services compared to non-Hispanic Whites. Results may prompt professionals to implement a case management intervention for all outpatient mental health facilities within the United States, and may provide researchers with information needed to enhance the mental health delivery system for African Americans

2003-2004 Young Musician Showcase

https://spiral.lynn.edu/conservatory_otherseasonalconcerts/1053/thumbnail.jp

Gene-centric meta-analyses of 108,912 individuals confirm known body mass index loci and reveal three novel signals

Recent genetic association studies have made progress in uncovering components of the genetic architecture of body mass index (BMI). We used the ITMAT-Broad-CARe (IBC) array comprising up to 49,320 single nucleotide polymorphisms (SNPs) across ~2,100 metabolic and cardiovascular-related loci to genotype up to 108,912 individuals of European ancestry (EA), African Americans, Hispanics, and East Asians, from 46 studies, to provide additional insight into SNPs underpinning BMI. We used a five-phase study design: Phase I focused on meta-analysis of EA studies providing individual level genotype data; Phase II performed a replication of cohorts providing summary level EA data; Phase III meta-analyzed results from the first two phases; associated SNPs from Phase III were used for replication in Phase IV; finally in Phase V, a multi-ethnic meta-analysis of all samples from four ethnicities was performed. At an array-wide significance (P<2.40E-06), we identify novel BMI associations in loci TOMM40-APOE-APOC1 (rs2075650, P=2.95E-10), SREBF2 (a sterol regulatory element binding transcription factor gene, rs5996074, P=9.43E-07) and NTRK2 (a BDNF receptor, rs1211166, P=1.04E-06) in the Phase IV meta-analysis. Of ten loci with previous evidence for BMI association represented on IBC array, eight were replicated, with the remaining two showing nominal significance. Conditional analyses revealed two independent BMI associated signals in BDNF and MC4R regions. Of the 11 array-wide significant SNPs, three are associated with gene expression levels in both primary B-cells and monocytes; with rs4788099 in SH2B1 notably being associated with the expression of multiple genes in cis. These multi-ethnic meta-analyses expand our knowledge of BMI genetics

The Wolbachia Genome of Brugia malayi: Endosymbiont Evolution within a Human Pathogenic Nematode

Complete genome DNA sequence and analysis is presented for Wolbachia, the obligate alpha-proteobacterial endosymbiont required for fertility and survival of the human filarial parasitic nematode Brugia malayi. Although, quantitatively, the genome is even more degraded than those of closely related Rickettsia species, Wolbachia has retained more intact metabolic pathways. The ability to provide riboflavin, flavin adenine dinucleotide, heme, and nucleotides is likely to be Wolbachia's principal contribution to the mutualistic relationship, whereas the host nematode likely supplies amino acids required for Wolbachia growth. Genome comparison of the Wolbachia endosymbiont of B. malayi (wBm) with the Wolbachia endosymbiont of Drosophila melanogaster (wMel) shows that they share similar metabolic trends, although their genomes show a high degree of genome shuffling. In contrast to wMel, wBm contains no prophage and has a reduced level of repeated DNA. Both Wolbachia have lost a considerable number of membrane biogenesis genes that apparently make them unable to synthesize lipid A, the usual component of proteobacterial membranes. However, differences in their peptidoglycan structures may reflect the mutualistic lifestyle of wBm in contrast to the parasitic lifestyle of wMel. The smaller genome size of wBm, relative to wMel, may reflect the loss of genes required for infecting host cells and avoiding host defense systems. Analysis of this first sequenced endosymbiont genome from a filarial nematode provides insight into endosymbiont evolution and additionally provides new potential targets for elimination of cutaneous and lymphatic human filarial disease

System Design for an Integrated Lifelong Reinforcement Learning Agent for Real-Time Strategy Games

As Artificial and Robotic Systems are increasingly deployed and relied upon for real-world applications, it is important that they exhibit the ability to continually learn and adapt in dynamically-changing environments, becoming Lifelong Learning Machines. Continual/lifelong learning (LL) involves minimizing catastrophic forgetting of old tasks while maximizing a model's capability to learn new tasks. This paper addresses the challenging lifelong reinforcement learning (L2RL) setting. Pushing the state-of-the-art forward in L2RL and making L2RL useful for practical applications requires more than developing individual L2RL algorithms; it requires making progress at the systems-level, especially research into the non-trivial problem of how to integrate multiple L2RL algorithms into a common framework. In this paper, we introduce the Lifelong Reinforcement Learning Components Framework (L2RLCF), which standardizes L2RL systems and assimilates different continual learning components (each addressing different aspects of the lifelong learning problem) into a unified system. As an instantiation of L2RLCF, we develop a standard API allowing easy integration of novel lifelong learning components. We describe a case study that demonstrates how multiple independently-developed LL components can be integrated into a single realized system. We also introduce an evaluation environment in order to measure the effect of combining various system components. Our evaluation environment employs different LL scenarios (sequences of tasks) consisting of Starcraft-2 minigames and allows for the fair, comprehensive, and quantitative comparison of different combinations of components within a challenging common evaluation environment.Comment: The Second International Conference on AIML Systems, October 12--15, 2022, Bangalore, Indi

Alcohol, Smoking, and Caffeine in Relation to Fecundability, with Effect Modification by NAT2

Common polymorphisms in the N-acetyltransferase-2 (NAT2) metabolic enzyme determine slow or rapid acetylator phenotypes. We investigated the effects of alcohol, smoking, and caffeine on fecundability, and determined whether the effects were modified by NAT2